Je Song, M.D.
Individual provider Active NPI General Practice Physician · Saucier, MS
NPI 1568509099 · NPPES record last updated Jan 19, 2011
Key facts
- NPI
- 1568509099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 17284 (MS)
- Practice address
- 19424 Saucier Lizana Rd
Saucier, MS 39574-9667 - Phone
- (228) 206-2681
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Past |
Accepting new patients |
| Stone County Hospital, Inc | Past | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 17284 | MS | |
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 17284 | MS | |
| Surgery Physician | 208600000X | 17284 | MS | |
| General Practice Physician | 208D00000X | 17284 | MS | Yes |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 17284 | MS |
Addresses
Primary practice location
19424 Saucier Lizana Rd
Saucier, MS 39574-9667
Mailing address
P.O. Box 1036
Picayune, MS 39466-1036
Phone (228) 206-2681
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04906363 | Medicaid | MS |
Other providers in Saucier, MS
- Thomas Anthony Mayer
- Molly Morris
- Nateladner LLC
- Jonathan Platner
- R & D Pharmacy LLC
- Southern Monitoring Innovations LLC
- Angel D Summers
- Mollie Kristine Winter
All providers in Saucier, MS · General Practice Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.